48-year-old male, with no history of medical interest or toxic habits, and no known allergies.
While working in the warehouse of a nuclear power plant, he was required to unload a lorry carrying 55% hydrazine hydrate. One of the drums accidentally fell to the ground, causing a spillage of about 25 litres, and the company's own emergency services were notified and diluted the 3 m2 area where the spillage had occurred with water. The patient actively participated in the collection of the waste, without using any personal protective equipment; at the end of the task he did not change his clothes or take a shower.
Several hours after the accident, he began to notice a reddening of the mouth with cheilitis of the lower lip, oral aphthae and diffuse abdominal pain. He was seen by a medical service, where he was prescribed symptomatic treatment. Six days after the accident, he developed erythematous scaly lesions on his face and arms (areas that were not covered during the accident). He therefore went to a hospital where he underwent a general blood test and simple chest and abdominal X-rays, which were normal, and was prescribed treatment with antihistamines.
Two weeks later, he visited the Toxicology Unit of the Hospital Clinic of Barcelona on his own initiative, due to persistence of the erythema-squamous lesions, abdominal discomfort and dysgeusia. The physical examination was normal and the blood and urine tests showed only a total bilirubin of 2.5 mg/dl (VN: up to 1.2 mg/dl) with an indirect bilirubin of 2.1 mg/dl. The abdominal ultrasound was normal. He was checked after one and three months and was found to be asymptomatic, although bilirubin remained slightly elevated, and he was discharged from the hospital.